Provider Demographics
NPI:1508297649
Name:MIDDLEBROOKS, DIONNE GIBSON (PT, DPT)
Entity Type:Individual
Prefix:
First Name:DIONNE
Middle Name:GIBSON
Last Name:MIDDLEBROOKS
Suffix:
Gender:F
Credentials:PT, DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:950 EAGLES LANDING PKWY # 936
Mailing Address - Street 2:
Mailing Address - City:STOCKBRIDGE
Mailing Address - State:GA
Mailing Address - Zip Code:30281-7343
Mailing Address - Country:US
Mailing Address - Phone:770-835-4647
Mailing Address - Fax:404-738-0050
Practice Address - Street 1:950 EAGLES LANDING PKWY # 936
Practice Address - Street 2:
Practice Address - City:STOCKBRIDGE
Practice Address - State:GA
Practice Address - Zip Code:30281-7343
Practice Address - Country:US
Practice Address - Phone:770-835-4647
Practice Address - Fax:404-738-0050
Is Sole Proprietor?:No
Enumeration Date:2013-11-27
Last Update Date:2024-04-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCP14236225100000X
VA2305207590225100000X
GAPT010710225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist